Suzanne E Jackson, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

LD00003628 Issued in WA

Practice address

550 17TH Ave
5TH Floor
Seattle, WA 98122-5788

Phone

(206) 386-3880

Fax

(206) 386-3882

NPI assigned

Jul 3, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Audiology Distribution, LLC

  • Audiologist-Hearing Aid Fitter
  • Dublin, OH
  • NPI 1164707998

  WA

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1578760476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4426",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 17TH AVE",
            "address_2": "5TH FLOOR",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225788",
            "telephone_number": "206-386-3880",
            "fax_number": "206-386-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUZANNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD00003628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I PROVIDER ACCT #",
            "identifier": "0218398",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500664133",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1092181",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharmell Jackson, CPC
• Shaun William Jackson, MD
• Stacy Latrice Jackson
• Susan Jackson, PA-C
• Susan Varner Jackson, PA-C
• Tamara E Jackson, P.A.
• Tyler Jackson
• Zultsetseg Wagner Jackson, PA-C
• Hannah Jacky, LSWAIC
• Jennifer Ellen Jacky, ARNP

• Audiologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Audiologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.